Melanie Cole, MS (Host): In a recent story, New York Times described sweeping changes made by Instagram. What are these changes and how are they affecting how our teenagers are using it? Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we're joined by Dr. Neela Sethi, she's a pediatrician on staff at Henry Mayo Newhall Hospital, and her extremely bright, informed, beautiful teenage daughter, Malika Young.

Thank you both for joining us. Malika, I'm so glad that you came back again because you're just a wealth of well-spoken information for Gen Z. I think you're even after Gen Z, right?

Malika Young: Gen Alpha.

Melanie Cole, MS: Gen Alpha. Okay. See? We're learning already. That's what these are all about. Okay. So, you and I have talked before about mental health and social media. Let's talk about Instagram. Do you use Instagram a lot? Tell us what it is because it's not something I use. TikTok, and now I use Snapchat just to talk to my kids. And obviously, all us oldies used Facebook and Twitter at one time. What is Instagram all about?

Malika Young: Yeah. I use Instagram mainly to keep in touch with friends and see what they're posting and what's going on in their lives. I don't find myself scrolling much on Instagram, only because the algorithm is so strong. And if I like or comment on one video about puppies, then my entire feed is about puppies. And I find that kind of boring because I like to explore new topics. So, I'll definitely scroll on other apps, but I definitely use it to keep in touch with friends and post myself about what's going on in my life.

Melanie Cole, MS: So, scrolling is one thing. Now, do you

feel when you look at Instagram, TikTok obviously has an algorithm. do you think that those regularly expose children and teenagers to bullying, are there instances that you've heard about from friends or relatives or something where there's sexual extortion, bullying, promoting self-harm? Have you seen any of that or heard about it?

Malika Young: Not that I've heard of. I know not on my feed at least. Again, the algorithm is so strong that I could see if you're liking videos about horrible things, then your entire feed is going to be about those things because Instagram just wants you to keep watching and keep watching, and it's going to do anything possible to get you to do that. So, I could see how that really strong algorithm is super harmful to people who are addicted to these sexual or horrible videos.

Melanie Cole, MS: I didn't know that. That's so interesting. And don't worry, Dr. Sethi, we'll get to you here. But, you know, more information from Malika. So, what are the changes that Instagram is making? They are directly designed for teenagers, yeah?

Malika Young: Yeah. From what I've heard, is that it's going to give you reminders to put down your phone. It will regulate messages from people that you don't already follow. It will regulate notifications after certain hours so that you're not staying up late on your phone. And it'll give an automatic private account to teens, to people under 18, or 16, I believe.

Melanie Cole, MS: Dr. Sethi, what do you think of this?

Neela Sethi, MD: I think you could probably guess what I think of it. I'm like overjoyed and think this is a huge step in the right direction. I think with the surge in general warning and the studies that we now know, even the book, The Anxious Generation, which is getting some really good traction, we know the harms of social media, especially when it started too young. And so, I think that just social pressure on Instagram and really all the social media platforms to try and protect our teens is a step in the right direction.

I think Molly's right, my well-informed teen, that, you know, if you're under 16, your account will automatically be set to private, which I think is huge. I think it really limits your access. You know, you're not really going to be getting messages from random people, at least going to be regulated. It's going to be people you're connected to. So, having your conversations with your teens about, okay, if you don't know this person or if it's a friend of a friend of a friend of a friend, they don't need to be following you in the intimate moments of your life. This is someone that you know in person that you've talked to.

They are doing some content restrictions as well in terms of like offensive words, and really trying to monitor for bullying or self-harm or just comments in general or topics in general that can be considered offensive, like eating disorder-related or self-harm-related content that, Molly's right, when you're liking it one time, the feed then becomes all of that. And so, they are trying to figure out how to restrict some of the negative content. Because if you can imagine, you can get sucked in. I've gotten sucked in to one specific topic, and it goes and goes and goes and goes. I've liked one recipe and it's like suddenly I'm watching 45 different soup recipes. But, you know, I'm also 47 and that's not harmful for me, but having some content restrictions definitely helps for sure.

And then, the timing, just even generalized alerts or Instagram will naturally be turned off for these teens from 10:00 PM to 7:00 AM. I think that's really helpful just to say like, "Okay, you're done. You know, you need to go to sleep now." And that's something that they're not going self-regulate as we all know. I get sucked in sometimes myself. But you know, when you're talking about a 12 and 13-year-old versus 17-year-old, it's quite a big difference in their young brains.

Melanie Cole, MS: I think that that's an excellent point that you just made about the sleep mode. And as you and I both know, we can get sucked into it. And I can sit there and go, "Oh, geez," you know, and then we regulate ourselves or we try depending on the level of addiction to social media. But I really appreciate the not being able to be contacted by randos, because even on Twitter, somebody DMs you or Facebook, somebody DMs you, you're like, you know, and you just delete it. But for kids, they may be like, "Oh." And you know, some of those randos have famous names. So, that always sort of throws me as well. I'm like, "Oh, look, Barry Manilow followed me on TikTok," which I know Barry Manilow did not follow me. you know, I see these things happen all the time. And Molly, has that ever happened to you, where famous people names, you know, fake names, have you been? Reached out to by any of these kinds of people?

Malika Young: I haven't, but I've have had circumstances where my friends have gotten hacked, and I've gotten random DMs from people from my childhood that I know wouldn't be reaching out to me, asking for money. And I automatically know that it's a hacker. But it is something that definitely needs to get handled, because I feel so bad for these teens that are just like getting their account hacked. My account's set to private, which is so important because see a lot of fishy accounts try and follow me, and I know that they would have seen my profile or tried to reach out to me otherwise if it hadn't been set to private, and I think that's so important for younger people.

Melanie Cole, MS: And you're able to disseminate and distinguish between the fake and the real. Because, I mean, I will say that, you know, you get this little flash of excitement for a second there. You're like, "Oh, well, maybe," "Ooh, really?" I mean, please, you know?

Malika Young: Yeah.

Melanie Cole, MS: So, what else do you feel about these social media platforms could be done better? I mean, now we're doing the sensitive content restrictions, sleep mode, privacy on your accounts, messaging restrictions. Is there anything else you would like to see?

Malika Young: Honestly, I think these rules are absolutely perfect. They give you protection while also letting you breathe a little bit. I think as a teen, I want my parent to have some trust in me and let me spread my wings a little bit. And rules align with those wants so perfectly. I think I'm able to have my social media and do what I want with it, but also I am protected as a young teen trying to grow and develop. And I think that's so, so important.

Melanie Cole, MS: I agree. And I think it's an important part of growth and development to learn to spot truth. That's critical thinking skills. And you obviously, Molly, have them just so much. You're so bright. But not every teen is going to have those critical thinking skills, so they're not going to regulate themselves or know that some random DM is really not the person they say they are, or that algorithm information. Dr. Sethi, is there anything else you would like to see changed in some of these social media? Do you think TikTok should do some kind of regulation, shutting down at 10:00, that sort of thing?

Neela Sethi, MD: One of the things that Instagram's doing that we hadn't touched on yet is that parents can see who their teens are DMing like over the course of a week. You can see who they're DMing. They can't see the content, but they can see who they're DMing. And I think that's important for parents to understand that they have to be involved in their kid's social media life. You know, I hear a lot from parents, "Well, I have no idea. I'm not even on it. I don't even know who they're talking to." And it's like, okay, that's a problem. If you don't know what's happening in your teen's life, yes, there's some element of trust and you can't go into those DMs and see what they're talking about. So, it still is giving them that privacy, which is important. And like Molly said, they do want to spread their wings, and they do want to have privacy, and we should honor that.

But flip that is you need to know if they're DMing the same person over and over and over for a week, and you don't know this person, that's a problem. That would completely similar to them having a brand new friend at school and seeing them all day every day, and calling them on the phone, all evening back in our day, and you wouldn't know who they were.

Melanie Cole, MS: How are you seeing it?

Neela Sethi, MD: There are settings that parents can use now with these teen accounts where they can log in and there's a connection between their account and their kid's account. And they see just who they're DMing in the last few days. week. So, I encourage parents when, and this is all happening as they're setting up their teen account for their child, and parents need to be informed. You know, they can't just write off social media anymore. And I see a lot of parents doing that. I hear that in my clinic, "I don't know. I mean, it's just too much. It's too complex." Guess what? This is the way we're moving in. This is the direction that society is moving in. If you want to give your teen access to the entire world in a tiny device that's in their hand 24/7, you need to be involved. You need to have the talks. You need to communicate. You need to know who they're talking to and what they're talking about. And you need to make sure that their feed is doing them a service. Just like we talked about in the last episode, Melanie, if your teen is coming off social media and looking sad and lonely and isolated and moody, that's a problem. You need to figure out what they're watching and who they're watching and who they're comparing themselves to or if their feed has gone awry and it's giving them false information.

So, I just encourage parents to say, yes, I understand that you want your teen to be independent. I am the biggest advocate for independence and them learning how to live independent lives. In addition to that, they live in your home. and you are setting them up for the real world so that when they go off to college, they know when they're getting those random DMs, or they're on their feed too much, or they're feeling lonely and sad to put their phone down, or to change the algorithm, or to unfollow people that could potentially be toxic for their mental health, and that's just part of human growth and development. That's part now of the diagram of what's required for parents in this day and age. So, wake up parents, get involved and ask the questions and if you have concerns, go online. They have YouTube tutorials, there are videos. You can find out how to be an involved parent, when it comes social media with your children very easily. You can go on social media and find out how to be involved with social media with your teens. It's that simple.

Melanie Cole, MS: Well, their teens can also sit with them, which would be a great bonding situation, as I am sure that you and Molly do, because sit with them and say, "This is how it's used, Mom, here's how you're going to set it up so that you can make sure that I'm safe on here." Molly, I want to give you the last word. When does this start? Has it started already? Have you noticed any difference? Are you getting that alert that, you know, maybe it's time to close out Instagram and shut your eyes or read a book before bed? Are you noticing any of these things? And tell parents listening, sort of reinforce what your mom just said, and teens, what you would like them to know about these changes and social media safety.

Malika Young: I personally think these changes are absolutely perfect. And I haven't seen any so far. I believe they're coming next year, I could be wrong about that, but I haven't seen any yet. I think steps that teens need to take to kind of make sure that these new changes aren't as shocking is silencing all notifications for Instagram, Snapchat, TikTok. I have all my notifications off, and it helps me put my phone down so much easier and it helps me to not gravitate towards it when I'm doing homework or trying to go to sleep. I also have my account on private, which I think so many of my friends would disagree with because they love the dopamine rush of getting a new follower that you don't know. But I see so many random follower requests coming in that would have seen my profile, if I hadn't had a private account.

And I think another thing that I do is I just put down my phone whenever I find myself doomscrolling. And I get reminders from my mom to put down my phone all the time. So, I think parents also need to be involved and check in on how long they're on this app, or there's free screen time trackers on your settings app that parents can look at to make sure their teens aren't constantly on it day after day.

Melanie Cole, MS: It's startling.

Malika Young: It is.

Melanie Cole, MS: I looked at mine and I was like, "Oh my God." Really kicked me in the head. But thank you so much to both of you. Molly, you're just so lovely and so full of information. And I know and hope that you will join us again because you're just really giving parents enlightening information that we don't always hear straight from a teenager's mouth. So, thank you so much.

And to take the free online social media and mental health assessments, visit the Henry Mayo Newhall Hospital online health library at library.henrymayo.com and type social media into the search box. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please remember to subscribe, rate, and review It's Your Health Radio on Apple Podcasts, Spotify, iHeart, and Pandora. I'm Melanie Cole. Thanks so much for joining us today.